FashionWholesaler.com
Fax / Mail Order Form

(Right-click and select the print option to print this page on your PC printer)
Please remember to send us a confirming email if ordering by fax to ensure that the appropriate dept. is anticipating your order. (Do not include your credit card info in the email.)

Item Code Description Color Qty Price Subtotal
           
           
           
           
           
           
           
** Estimated Ground Shipping Rates
Min. ordering amount US$150.00
$150 - $200.00
$200.01 - $250.00
$250.01 - $300.00
$300.01 - $350.00
$350.01 - $400.00
$400.01 - $450.00
$450.01 - $500.00
Over $500.00
International order
 		  Order Total = $16.00
  Order Total = $18.00
  Order Total = $20.00
  Order Total = $23.00
  Order Total = $25.00
  Order Total = $28.00
  Order Total = $30.00
  Contact us
  Contact us
UPS GROUND - US ONLY
ORDER TOTAL
  
Sales Tax
8.25% (CA residents)		  
Shipping  
Total  
** The shipping rate shown on above order form is only for estimated ground shipping service. The shipping charge will be manually adjusted for each order.
Full Name (As it appears on credit card)
 
Street Address (As it appears on your credit card statement)
 
 
Phone  (        )                               E-mail:

 [   ] Money Order (No COD)    

 [   ] Discover

 [   ] Visa

 [   ] Master Card
 [   ] American Express 

Fax  Orders to:

(562) 404-0181

Mail Orders to:

FashionWholesaler.com
16641 Valley View Ave.

Cerritos, CA 90703
Credit Card # Exp. Date
 
/
  Signature:

Please send a confirming email when ordering by fax. Do not include your payment information. info@FashionWholesaler.com

If you do not feel comfortable ordering over the internet, use this form to
fax or mail your order to FashionWholesaler.com